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Biomedical subjects

H Dickel

Publications and source records attributed to H Dickel.

At least 19 recordsLinked to original sources
PubMed2005

[Evidence-based evaluation of the effect of Type IV Allergies on the reduction of fitness for work. Survey of occupational skin diseases].

Evidence-based guidelines about the distribution of type IV allergens of the European standard series in different professions and its occupational relevance are missing. Based on published data, epidemiological investigations, work related knowledge about industrial processes, and allergen specific properties, recommendations are given about the clinical impact in the working environment for the following allergens: acrylates/methacrylates, epoxy resins, dichromate, cobalt, nickel, formaldehyde, (chlor-)methylisothiazolone, p-phenylendiamine, colophony, thiurame, mercaptobenzothiazole, dithiocarbamate, n-isopropyl-n'-phenyl-p-phenylendiamine, fragrance mix, composite mix, and neomycinsulfate. These recommendations might improve the clearance rate and allergological evaluation of the occupational relevance of different delayed type sensitizations or allergens.

Allergens↗
PubMed2004

[New dermatologist's procedure. Research plans for improving secondary prevention of occupational dermatoses].

The dermatologist's procedure was introduced in 1972 by employers' liability insurance funds in the industrial, agricultural, and public sectors of Germany's statutory occupational accident insurance as a "procedure for early detection of occupational skin diseases." So far, it is still the most relevant tool for secondary prevention in occupational dermatology in Germany. According to the intention of this procedure, insured persons with a skin disease in which an occupational etiology is suspected must be offered preventive measures and, if necessary, given appropriate treatment to avoid job-loss. To improve the efficiency of the "classic" dermatologist's procedure, in 1999, on the initiative of the Central Federation of Industrial Professional Associations, a study group was founded in cooperation with the Task Force on Occupational and Environmental Dermatology of the German Dermatological Society and the Professional Organisation of German Dermatologists. In October 2002, a controlled intervention study started in North-western Germany to scientifically evaluate the "optimised" dermatologist's procedure, which was proposed by the study group and compare it to the standard ("classic") procedure. The study results should allow detailed suggestions for an improved dermatologist's procedure before it is introduced nationwide.

Cross-Sectional Studies↗
PubMed2003

Early secondary prevention of occupational skin disease in Germany: the dermatologist's procedure in perspective.

The dermatologist's procedure was introduced in 1972 as a "procedure of early detection of occupational skin disease" by industrial, agricultural and public-sector employers' liability insurance funds of Germany's statutory occupational accident insurance. To date, it represents the most relevant tool for secondary prevention in industrial dermatology in Germany. According to the intention of this procedure, insured parties who are likely to have an occupational skin disease have to be offered preventive measures and, if necessary, given appropriate treatment to avoid job-loss. In co-operation with the Central Federation of the Industrial Professional Associations, the Task Force on Occupational and Environmental Dermatology of the German Dermatological Society, and the Professional Organisation of German Dermatologists, a study group was constituted in 1999 to improve the traditional dermatologist's procedure. In October 2002 a controlled intervention study was started in North-western Germany to establish the definitive value of the "optimised" dermatologist's procedure. Past, present, and future of this specific procedure are discussed.

Dermatology↗
PubMed2002

Occupational relevance of positive standard patch-test results in employed persons with an initial report of an occupational skin disease.

OBJECTIVES: It is commonly accepted that the standard screening tray is an essential diagnostic test in patch testing supporting the diagnosis of contact dermatitis, the most common type of occupational skin disease (OSD). In this study standard patch-test results of employed persons with an initial report of an OSD were analyzed within 24 occupational groups. METHODS: An evaluation was made of employed persons recorded in the Register of Occupational Skin Diseases in Northern Bavaria (Berufskrankheitenregister Haut-Nordbayern; BKH-N) between 1990 and 1999, catering for those standard screening tray allergens tested over the 10-year period. RESULTS: Nickel sulfate was the most common sensitizer (29.5%), showing occupational relevance in only 11% of the cases sensitized. Other common sensitizers were cobalt chloride (13.5%), p-phenylenediamine free base (10.7%), potassium dichromate (9.8%), fragrance mix (5.4%), thiuram mix (4.2%), balsam of Peru (4.0%), chloromethylisothiazolinone/methylisothiazolinone (4.0%), and formaldehyde (4.0%). The most occupationally relevant sensitizers were thiuram mix (71%), epoxy resin (67%), p-phenylenediamine free base (59%), p-phenylenediamine-black-rubber mix/ N-isopropyl- N'-phenyl- p-phenylenediamine (53%), potassium dichromate (48%), formaldehyde (38%), chloromethylisothiazolinone/methylisothiazolinone (37%), and mercapto-mix/mercaptobenzothiazole (35%). Occupational groups at risk of acquiring delayed-type sensitization were, in particular, electroplaters, tile setters and terrazzo workers, construction and cement workers, solderers, wood processors, and leather and fur processors. CONCLUSIONS: The standard series contributes valuable information and asserts its position in clarifying the causes of OSDs. Based on the study results, the rate of occupationally relevant sensitization to each single allergen is demonstrated, and the difficulties in verifying the occupational relevance are discussed.

Adult↗
PubMed2002

Surveillance scheme for occupational skin disease in the Saarland, FRG. First report from BKH-S.

Occupational skin disease (OSD) is a significant public health concern. To keep OSDs under surveillance, a register of OSDs (BKH-S) was implemented in 1999 in the Saarland, FRG. We conducted a population-based register study to analyse all initial reports of OSDs reported to the BKH-S. 336 cases were prospectively assessed from July 1999 to June 2001. In 78% (n = 263) of the cases an occupational cause for the skin disease was stated, 91% (n = 240) of which fell within 16 occupational groups. This is equivalent to 6.8 cases per 10,000 workers per year within these occupational groups. Notably, young age groups (median age 35 years) were affected with a female predominance. The most frequent final diagnosis was irritant contact dermatitis (75%) followed by allergic contact dermatitis (34%) and atopic dermatitis (19%). The overall prevalence of occupationally relevant delayed-type reactors was 21% and of immediate-type reactors 17%. Work-related delayed-type sensitizations to potassium dichromate (n = 8) and immediate-type sensitizations to natural rubber latex (n = 11) were the most frequently observed. Questionnaire results showed frequent occupational skin contact with wet work (59%), detergents (48%), and disinfectants (38%). The second valid surveillance scheme for OSD in the FRG has been introduced and can be made available for further analysis.

Adult↗
PubMed2002

Impact of anatomical location on barrier recovery, surface pH and stratum corneum hydration after acute barrier disruption.

BACKGROUND: It is not known whether distinct anatomical locations will respond with different recovery rates following acute barrier challenges. OBJECTIVES: To investigate whether barrier parameters differ at five body sites during recovery from acute disruption. METHODS: Acute barrier disruption was achieved by tape stripping and by acetone extraction of stratum corneum lipids. Transepidermal water loss (to assess barrier function), capacitance (for stratum corneum hydration) and skin surface pH were measured at each of five different body sites in 14 human volunteers. Individual measurements were obtained every 24 h for 96 h. RESULTS: Lipid-rich skin areas (e.g. the forehead) were the most vulnerable to barrier disruption by either method. While acetone treatment affected barrier function and decreased stratum corneum hydration, tape stripping similarly altered barrier function but increased capacitance values. Although the effect of barrier disruption on surface pH appeared to vary with location, no significant pattern of variation emerged. Independent of the method used for barrier disruption, the pH normalized within 96 h. CONCLUSIONS: Skin at different body sites shows distinct patterns of barrier recovery that are likely to be related to structural and physiological differences. Therefore, 'anatomically specific' regimens appear possible and relevant for the treatment of cutaneous disorders. In addition, adequate statistical analyses are essential to detect real differences in barrier recovery parameters.

Acetone↗
PubMed2001

[Incidence of occupation-related skin diseases in skin-exposure occupational groups].

BACKGROUND AND OBJECTIVE: Occupational skin diseases (OSD) rank at the top of occupational diseases in Germany. We studied the cases with initial medical report of an OSD reported to our Register of OSD in North Bavaria (BKH-N). PATIENTS/METHODS: From 1990-99 5.285 cases were closed and recorded. Since the number of employees in the different occupations was known, a population-based study was performed to investigate incidences and demographic characteristics in occupations classified into 24 groups. RESULTS: In the occupational groups in 3.097 cases a work-related skin disease was stated. The estimated overall incidence was 6.7 cases per 10,000 workers per year. The highest incidence was in hairdressers (97.4), bakers (33.2), and florists (23.9), while the largest number of cases was in hairdressers (856), health services (481), and metal-surface workers (260). The median age of all cases was 25 years. In 1.611 cases (52%) a delayed-type sensitisation with occupational relevance was perceived. CONCLUSIONS: The descriptive data of the BKH-N highlight occupational groups being at risk for OSD. The results assist in working out prevention measures aiming on lowering the incidence of OSD.

Adult↗
PubMed2001

Occupational skin diseases in Northern Bavaria between 1990 and 1999: a population-based study.

BACKGROUND: Occupational skin diseases (OSDs) account for a large portion of occupational diseases in Europe, but population-based epidemiological studies are missing. OBJECTIVES: We analysed the initial reports of OSDs in our register of OSDs in Northern Bavaria (BKH-N). METHODS: A total of 5285 cases were assessed prospectively and registered from 1990 to 1999. As the German Federal Employment Office provides specific occupational data in relation to the total employed population of Northern Bavaria, it was possible to conduct a population-based study that investigated the trend in incidence rates between two study periods (1990-92 and 1993-99) in 24 different occupational groups. RESULTS: A total of 3097 cases of OSD (median age 25 years) were recorded in the 24 occupational groups. There was a significant decline (P < 0.001) in the overall incidence rate of OSD with 10.7 cases per 10,000 workers per year for the first study period and 4.9 cases per 10,000 workers per year for the second study period. This general trend in incidence rates was also significant for hairdressers and barbers, bakers, health-care workers, cooks and metal processors. CONCLUSIONS: The BKH-N provides national data based on the notification of OSDs in Germany. The results demonstrate the rank of occupations hazardous for the skin and are helpful for defining target groups for prevention.

Adult↗
PubMed2001

Comparison of patch test results with a standard series among white and black racial groups.

BACKGROUND: Environmental, cultural, occupational, genetic, individual, and racial differences are important factors in the study of contact dermatitis. Some epidemiologic studies have compared overall sensitization rates among different racial groups, but similar data are lacking on individual allergens. OBJECTIVE: Determine differences in sensitization rates between 2 racial groups in North America undergoing patch testing over a period of 4 years at the Cleveland Clinic Foundation (CCF), Ohio. METHODS: Retrospective computer review of the standard screening tray results of 991 patients with an average age of 45.9 years consisting of 877 (88.5%) whites and 114 (11.5%) blacks. RESULTS: Nickel sulfate and thiomersal (both 8.0%) and nickel sulfate and p-phenylenediamine (both 10.6%) were the 2 most common sensitizers among whites and blacks respectively. There was a statistically significant difference (P =.00599) in the sensitization rate for p-phenylenediamine in blacks (10.6%) compared with whites (4.5%). There were also statistically significant differences in sensitization rates for p-phenylenediamine (21.2%; P =.00005) and imidazolidinyl urea in petrolatum (pet.) (9.1%; P =.04103) in black men compared with white men (p-phenylenediamine [4.2%] and imidazolidinyl urea [2.6% pet.]). CONCLUSION: The differences in sensitization rates, especially for p-phenylenediamine, may reflect variations in allergen exposure among racial groups or interindividual variations in the N-acetylation (N-acetyltransferase 1 [NAT1] and 2 [NAT2]) capacities of human skin for p-phenylenediamine.

Allergens↗
PubMed2000

Delayed readings of a standard screening patch test tray: frequency of "lost," "found," and "persistent" reactions.

BACKGROUND: Several studies have shown that patch test results vary depending on the time at which the patch test sites are evaluated. OBJECTIVE: This study aims to determine the frequency of "lost," "found," and "persistent" reactions to a standard screening tray by comparing initial and delayed readings of the same patch tests. METHODS: We performed a retrospective review of patch test reactions for 587 patients tested with the standard screening tray at The Cleveland Clinic Foundation (Cleveland, OH) between January 1, 1988, and December 31, 1991, for which an initial day-3 and delayed day-4 to day-8 readings were available. RESULTS: For the 587 patients, we identified 81 found (15%), 342 persistent (62%), and 127 lost (23%) reactions, for a total of 550 reactions (100%). The three most common found reactions were to neomycin sulfate (n = 19; 53%), p-phenylenediamine (n = 10; 29%), and thiomersal (n = 10; 18%). The three most common persistent reactions were to thiomersal (n = 41; 73%), nickel sulfate (n = 33; 73%), and quaternium 15 (n = 32; 74%). The three most common lost reactions were to balsam of Peru (n = 14; 39%), benzoyl peroxide (n = 12; 63%), and nickel sulfate (n = 9; 20%). CONCLUSION: Two patch test readings are necessary, followed by a final interpretation.

Dermatitis, Allergic Contact↗
PubMed1999

Interdisciplinary clinical assessment of patients with illness attributed to environmental factors.

Patients with health problems attributed to environmental factors such as chemical pollutants and electromagnetic fields often do not present evidence of an environmental aetiology of their symptoms. It has been postulated, that their problems are due to disorders diagnosed by other medical disciplines, especially allergology and psychiatry. Our study was designed to subject these patients to a comprehensive diagnostic program involving several medical disciplines in order to achieve diagnoses appropriate to explain the patients' symptoms. Fifty patients consecutively referred to the department of environmental medicine in the university hospital of Aachen, Germany, were submitted to the following examinations: (i) environmental medicine (history, clinical examination, biological and/or ambient monitoring for environmental agents); (ii) allergological examination (history, clinical examination, skin tests); (iii) psychiatric examination (psychopathological examination, psychometric and neuropsychological testing). In addition, the patients were examined in other hospital departments according to the symptoms presented. The findings were discussed in case conferences attended by the physicians involved in order to achieve individual diagnoses. The numbers of patients to whom diagnoses were given by different medical disciplines are as follows: psychiatry (32 patients), dermatology (4), allergology (2), neurology (2), rheumatology (2), gynaecology (1), haematology (1). The most frequent mental disorders diagnosed by the psychiatrists were somatoform disorders (19), followed by schizophreniform and delusion disorders (7). In spite of extensive diagnostic efforts, patients with health problems attributed to the environment usually do not present sufficient evidence of an environmental aetiology of their symptoms. On the other hand the symptoms often meet the diagnostic criteria of other diseases, especially of mental disorders.

Adult↗
PubMed1981

[Comparison of the efficiency of the Soviet culture medium no. 3 and the media used for cultivation of mycobacteria in routine in the GDR (author's transl)].

In cooperation of ten laboratories the Soviet culture medium Mo. 3 (FINN) was compared with the media used in the GDR for primary cultivation of mycobacteria in routine (German Pharmacopoeia (diagnostic laboratory methods) GDR). The efficiency of the media tested in the study was nearly the same, not only concerning the number of positive cultures but also in time of growth and the number of colonies.

Bacteriological Techniques↗
PubMed1978

[Diagnosis of anthrax and para-anthrax with reference to immunofluorescence technic].

504 diagnostic samples were subjected to a fluorescence serology and culturah test for black quarter and malignant oedema. In 459 cases (91.1%) the results of both testing methods wede identical. 26 first results were made by culture (14 X malignant oedema, 12 X black quarter). 19 results (14 malignant oedema, 5 X black quarter) were obtained by immuno-fluorescence only. Culture was shown to be not significantly better than fluorescence, especially in determining black quarter. In the diagnosis of black quarter and malignant oedema the combination of immunofluorescence with culture can be considered as the optimal testing method available at the present time, in that by this method there would be no need for an additional diagnostic test on the animal.

Animals↗